| NPI | 1417381120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 52641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74153) |
| 207R00000X Internal Medicine (Licence: AZ 52641) | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2023-09-29 |